title: Prevalence of psychotic symptoms in those with melancholic and nonmelancholic depression.
abstract: The best classification of depressive disorders is still to be established. A melancholic subtype has a lengthy history, and recent research demonstrates its relevance. This study compares the prevalence of psychotic symptoms in nonmelancholic and melancholic depression and assesses whether there is a dimensional pattern in the severity of symptoms among the subtypes. Patients with unipolar depression were assessed for melancholic status, psychotic symptoms, and severity of depression. The diagnosis of melancholia was made by both Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), criteria and CORE measure. The DSM criteria assigned a much higher percentage of patients as melancholics (67.4%) than did the CORE (24.9%). Prevalence of psychosis was distinctly higher in the melancholics. Symptoms severity was higher among the melancholics when compared with the nonmelancholics. The presence of psychotic symptoms was not associated with an increase in the intensity of depressive symptoms. Psychotic symptoms are more frequently associated with the melancholic subtype of depression. This suggests clinical contiguity between the melancholic and psychotic subtypes and the clinical relevance of identifying melancholia.
authors.affiliation: *Universidade Federal do Rio Grande do Sul, Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; and †Black Dog Institute, Prince of Wales Hospital, Randwick, New South Wales, Australia.
authors.forename: Marco Antonio
authors.initials: MA
authors.lastname: Caldieraro
authors.forename: Fernanda Lúcia Capitanio
authors.initials: FL
authors.lastname: Baeza
authors.forename: Diesa Oliveira
authors.initials: DO
authors.lastname: Pinheiro
authors.forename: Mariana Rangel
authors.initials: MR
authors.lastname: Ribeiro
authors.forename: Gordon
authors.initials: G
authors.lastname: Parker
authors.forename: Marcelo P
authors.initials: MP
authors.lastname: Fleck
mesh_terms: D000328:Adult; D015897:Comorbidity; D003866:Depressive Disorder / Q000145:classification* / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000145:classification* / Q000175:diagnosis / Q000453:epidemiology; D012720:Severity of Illness Index